The association is a fundamental building block in the way that most societies organise themselves. You might perhaps expect the Society of Printing Professionals or the Federation of Birdwatchers to have similar models, but the fact is that medical associations have developed a particularly important role in our society and now face set of challenges that reflect not only the reality of their specific profession but also the way in which we perceive them.
This is not entirely surprising when you consider the public’s personal interaction with the medical profession as patient, family and taxpayer. In the OECD healthcare represents between 6% and 9% of GDP, with each of us spending €5,000 per year on healthcare and seeing the doctor as many as 9.7 times a year in Germany!
Medical associations share many common characteristics. They typically depend on the voluntary professional activity of individuals to drive a not-for-profit business model. Their business is to represent the interests of the profession, to use collective knowledge to define standards, to define policy and to be a trusted voice for the public. Yet, beyond those similarities, medical associations are hugely diverse in terms of business model, geography, community, size and of course budget – the mix of challenges they are facing will therefore vary from group to group as well.
There are also some fundamental demographic changes that are revolutionising the way healthcare professionals work and how they come together. Consider the organisational implications of the gender flip in many specialties where women are already outnumbering men, consider the massively divergent but simultaneous expectations of three generations of members and their widely divergent levels of digital literacy. Consider also a global healthcare workplace where not only workers but also disease and epidemics are mobile, where technological advance comes from the least expected source and where previously underestimated importance is given to our lifestyle.
Meanwhile individual work-life balance choices are changing and the commitment to join, contribute and attend society activities may differ from earlier periods. As our society evolves our medical associations are experiencing transformation within.
Regulation and other forms of governance-related disruption are also driving change in the way that medical associations do business. Anti-corruption legislation, healthcare reform, voluntary industry codes, employers, the general public, patient groups are all actively engaging with medical associations and making them rethink almost everything they do. Industry budgets are slashed or re-aligned, grant support is harder to get, board decision making is questioned, committee expertise is disputed, transparency is demanded and your trip to the next world congress is put in doubt.
And the pressure is not only external, governing boards and leadership are increasingly put to task by a new generation of member, delegate or contributor who expect their voice to be heard. Simultaneously special interest groups are strengthened at a time of ever greater specialisation. Social media only amplify these divergent and often challenging voices, increasing the pressure of internal and external scrutiny.
Most of the issues I mention are expressed in terms of competition for resources, for people, for time and for recognition – all of which are compounded by global financial, economic and political uncertainty. However, we are confident that the very characteristics and values that have driven the spectacular success of the medical association business model will allow them to thrive in the future. Medical associations must defend their independence, leverage their legitimacy and be agile enough to engage their constituencies in new ways.